title: Gunshot wounds to the face: emergency interventions and outcomes.
abstract: BACKGROUND
  Gunshot wounds to the face (GSWF) may produce life-threatening injuries. Our objective is to describe outcomes of and factors related to interventions for urgent airway control (UAC) and urgent bleeding control (UBC) as well as to analyze complications associated with GSWF.
  
  
  METHODS
  This was a retrospective study of 155 GSWF patients who were admitted to two Level 1 academic trauma centers over an 11-year period. Demographic details, injuries sustained, interventions performed, and timing of the interventions were recorded. Morbidity and mortality data were evaluated.
  
  
  RESULTS
  Overall, 115 (74 %) patients suffered isolated GSWF, and none died. Of the 90 (58 %) patients requiring UAC, only three had a cricothyroidotomy. Of the 41 (26 %) patients requiring UBC, only four had angiographic embolization. Intraoral involvement and extrafacial injuries were associated with both UAC and UBC. Overall, 75 patients (48 %) required operations on the bones, eyes, or both. Complications developed in 14 and were treated successfully.
  
  
  CONCLUSIONS
  UAC and UBC are required frequently after GSWF and are associated with intraoral involvement and injuries beyond the face. Simple methods, such as orotracheal intubation and packing, are typically sufficient for successful management. About half of the patients need further surgery, with infrequent morbidity.
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, Boston University Medical Center, 820 Harisson Avenue, FGH 4, Boston, MA 02118, USA. george.orthopoulos@bmc.org
authors.forename: George
authors.initials: G
authors.lastname: Orthopoulos
authors.forename: Antonios
authors.initials: A
authors.lastname: Sideris
authors.forename: Elpida
authors.initials: E
authors.lastname: Velmahos
authors.forename: Maria
authors.initials: M
authors.lastname: Troulis
mesh_terms: D000293:Adolescent; D000328:Adult; D058109:Airway Management / Q000379:methods / Q000706:statistics & numerical data; D001900:Boston; D004638:Emergency Treatment / Q000379:methods / Q000706:statistics & numerical data; D005151:Facial Injuries / Q000150:complications / Q000401:mortality / Q000628:therapy*; D005260:Female; D006489:Hemostatic Techniques / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D012042:Registries; D012189:Retrospective Studies; D014193:Trauma Centers; D016896:Treatment Outcome; D014948:Wounds, Gunshot / Q000150:complications / Q000401:mortality / Q000628:therapy*; D055815:Young Adult